Dromomania: causes, manifestations, treatment of pathological wanderlust

Dromomania (from the Greek “running” and “craziness”) is an unreasonable desire to travel. A penchant for changing places and a thirst for visiting beautiful surroundings is inherent, perhaps, in every second inhabitant. And this is quite normal for relaxation and relaxation, but when such thirst develops into a pathological passion and constant aimless wanderings around the world - this is already a clinic. Dromomania affects people with mental illness, as well as teenagers. Maxim Gorky, who grew up in the house of an overbearing grandfather and ran away from home more than once, had a clinical form of dromomania, so in his works he often described the life of tramps. We will talk in detail about the manifestations and treatment of the disease.

Symptoms of dromomania

Probably every reader involuntarily thought that he had dromomania. However, this phenomenon is not just an impulse of the soul or a hobby, it is a mental illness, which is based on an organic dysfunction of the brain. The disease can be diagnosed by the following symptoms:

• Spontaneity.

  Each subsequent impulse to leave the house occurs suddenly, without obvious reasons. A person can suddenly get up in the middle of the working day or during lunch and go wandering.

• Complete irresponsibility.

  The patient does not warn either relatives, colleagues, or superiors about his absence; he can abandon a report he has started or a helpless child and go nowhere.

• Absolute aimlessness and lack of plan.

  During the next dromomanic attack, a person can go traveling in a robe and slippers or even pajamas, without taking any clothes, money or documents with him. Dromomaniacs often hitchhike, spend the night in the open air, beg, look for odd jobs, and do not take care of their appearance.

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• Lack of awareness of actions.

  Patients explain their sudden impulses and suitcase mood by the appearance of feelings of anxiety, restlessness, and an inexplicable desire for a change of scenery. The beginning of an attack of dromomania resembles delusions, hallucinations, which only decrease on the road, and the person begins to realize that he is doing something wrong. When the irresistible thirst to travel subsides, the patient himself returns home.

• When examining people with bouts of dromomania on magnetic resonance imaging, it is noticeable changes in the functioning of the temporal lobes of the brain

  , excessive neuronal activity in this area.

Impulsive drives

Impulsive drives, which were previously designated as monomania, manifest themselves episodically or periodically arising uncontrollable urges to commit socially unacceptable, including illegal actions, often or even most often contrary to the conscious needs of the individual. Most impulsive impulses arise suddenly. Their appearance is preceded by growing affective tension, sometimes a short struggle of motives, and attempts to resist a rapidly growing impulse.

During a painful episode, the pathological urge is perceived by the patient as a passionate, “wild” and uncontrollable desire to realize this urge. The painful episode ends after some time with a feeling of great relief: the pathological urge fades away, disappears into the abyss of the unconscious, but patients, even in a normal state, somehow feel that it still exists, or notice that it leaves traces in the form of some then thoughts, interests, actions. If patients have not lost the ability to objectively evaluate such episodes, they understand their morbidity and alienness to the conscious mind. Ya E. Bleuler, referring to homocidal impulsive desire, points out: “Crime seems to be accompanied by clouding of consciousness and even a real hysteriform twilight state... Criminals usually cannot indicate no explanation for your actions,” as if thereby emphasizing the fact of amnesia of the motives of painful behavior. Often the actions and the environment in which the pathological actions were committed are amnesic. After emerging from a painful episode, E. Bleuler continues, various sociopathic manifestations may be identified in patients, but this cannot be considered a mandatory rule, since “otherwise, these people can be quite moral (and) decent.”

Cases in which the patient would commit impulsive acts of various types seem to be quite rare, if at all. The duration of individual impulsive episodes ranges from several minutes, hours (kleptomania) to a number of days, weeks and even months (dromomania, dipsomania, fugues). Patients vary widely in terms of the frequency, rhythm, and frequency of recurrent impulsive episodes. The latter can be facilitated by factors such as intoxication, menstruation, nostalgia, stress, digestive disorders, mood changes (depression, dysphoria), and some random circumstances. These factors can trigger an impulsive episode, but are not the main cause. The nosological affiliation of impulsive drives remains not entirely clear. The number of currently distinguished impulsive drives ranges from 4 to 10 or more. In ICD-10, trichotillomania is classified as impulsive drives. Let us describe the main ones.

1. Pyromania is an impulsive urge to set fires that does not pursue the goal of causing material or other damage to anyone. Pyromaniacs tend to set fires repeatedly; Usually, patients have time to carefully prepare them, carry them out with dexterity, and often skillfully hide the traces of the act, so that it is not easy to incriminate the patients. Watching the fire, they seem to be fascinated by it for some time, and then they can take part in putting it out, feeling satisfaction from their help.

Let us remember that, unlike pyrolagnia, pyromaniacs do not experience sexual feelings. In the intervals between attacks of pyromania, patients are often interested in everything that is in one way or another connected with fire and fires (reports of fires, fire equipment, fire extinguishing means, flammable substances, the sight of burned people, etc.). An episode of pyromania is not amnesiac. Some pyromaniacs experience a feeling of guilt and, although they rarely admit to their crime, they may feel relieved when they are detained by law enforcement officers. Pyromania is a relatively rare phenomenon (there is no exact data on its distribution); it is more often found in men, who are more likely to show signs of mild mental retardation and a tendency to abuse alcohol. In childhood, some pyromaniacs show cruelty to animals and a tendency to commit arson. Women who are pyromaniacs exhibit a tendency toward sexual promiscuity and petty theft, sometimes reminiscent of kleptomania.

The etiology of pyromania is unknown. Psychodynamic theories (fire is a symbol of sexuality, heat excites the same feelings, the shape and movement of the flame remind the patient of the penis; pyromania expresses the phallic desire for power and social prestige, and putting out a fire proves courage and one’s strength, etc.) have not received evidence. No connection was found between the disorder and any known mental illness, although long-term follow-up data are not provided in the literature. In episodes of pyromania, there are undoubtedly signs of altered consciousness and self-awareness, which may indicate that the disorder is similar to the phenomenon of multiple personality, as well as other impulsive drives. In this case, impulsive drives serve as a manifestation of a very long prodromal or initial stage of schizophrenia in the form of a psychopathic syndrome. Treatment (mainly behavioral psychotherapy) is ineffective.

2. Kleptomania - episodes of impulsive urges to commit petty thefts, not pursuing the goal of enrichment. As unnecessary things are stolen, they are then thrown away, returned to the owner under a plausible pretext, or for some reason kept and accumulated, although we are not talking about kleptolagnia or theft of sexual fetishes. At the moment of theft, patients seem to experience some pleasure and a sense of relief, temporarily freed from the tension of the painful impulse.

Sometimes thefts are not planned, the patient does not seem to prepare for them, and behaves insufficiently carefully; exposing such patients is not difficult. Some patients have been stealing for a number of years with remarkable dexterity, so that it is quite difficult to catch them. Thus, a recently identified kleptomaniac was found at home with a whole warehouse of stolen CDs, even in unopened boxes: he had been stealing for more than ten years. Thefts are committed alone with different frequencies, reflecting the dynamics of the painful impulse. After episodes of kleptomania, patients often experience anxiety, guilt, and even depression, but the disorder nevertheless persists.

A feeling of shame stops patients when they think about reporting themselves somewhere, but arrested patients sometimes thank the police for finally catching them. Kleptomania is detected in less than 5% of thieves. Once upon a time, kleptomania was very often feigned. Kleptomaniacs never become ordinary thieves, and vice versa. The combination of kleptomania and ordinary theft, if it occurs, is extremely rare. Isolated cases of kleptomania occur in patients with obsessions—ritual theft. It is believed that kleptomania is more often observed in women, who are supposedly more prone to ordinary theft. There are cases when the disorder persists into old age. There is a known case where a kleptomaniac was already over 70 years old and she was arrested more than 60 times.

Kleptomania is often combined with chronic depression, anorexia nervosa, bulimia and pyromania (in women); episodes of kleptomania can occur after stress.

The nature of the disorder is unknown. Psychoanalysts associate kleptomania with such reasons as attempts to restore the lost mother-child relationship, aggression, women's search for the penis or its symbol, protection from the castration complex, masochism (search for punishment), the desire to maintain positive self-esteem or restore it, reaction to a family secret, replacement sexual intercourse. Psychodynamic theories have not been confirmed, at least not yet. Kleptomania is a personality disorder, possibly of process origin in the form of a psychopathic syndrome.

The course of kleptomania is wavy, periodic, and generally chronic. Kleptomaniacs themselves extremely rarely seek medical help on their own; in remission, they either calm down and think that the disorder has passed, or they don’t think about it at all, as if they forget. Socially, many kleptomaniacs are adapted quite well, if their bad reputation does not harm them. Cases of theft by psychiatric patients (in mania, under the influence of auditory deception, etc.) are usually not kleptomania. The disorder cannot be treated.

3. Dipsomania is an impulsively occurring uncontrollable urge to drink in people who do not show signs of alcohol dependence. Binges last up to a number of weeks. Patients drink mostly alone, almost all day long, absorbing gigantic quantities of alcohol. Thus, the patient reports that he drinks up to 6 liters of vodka per day during a binge. Characterized by super-endurance of alcohol. In behavior, patients become unrecognizable: extremely aggressive, cruel, prone to sexual excesses and deviations, as well as to dromomania. They partially remember their behavior during the period of heavy drinking, and they are surprised to learn many details from friends.

Binges occur relatively rarely - once every year or two or more. They stop suddenly. The attraction to alcohol is replaced by complete indifference or disgust towards it. Subsequently, if patients drink at all, it is in moderation, as before the attack of dipsomania; there is alcohol intolerance. There are indications of a connection between dipsomania and affective disorders (dysphoria, depression).

4. Attacks of nymphomania and satyriasis are impulsively occurring attacks of sexual passion, sexual obsession in women and men who, in their normal state, are not inclined to hypersexuality or even with hypo- and alibidemia. The attacks begin suddenly, last up to several hours or days, then end just as abruptly. One of the patients with schizophrenia suffered from attacks of satyriasis that lasted up to two hours.

Outside of attacks, he had no interest in women. Eyewitnesses said that during the attack he became “completely wild, running around foaming at the mouth” in search of a victim. He himself associated such attacks with the fact that someone secretly put “Spanish flies” in his food. Sexual urge, however, was perceived by him as “a terrible desire of a woman.”

He had no cases of sexual violence, since he worked at a remote weather station, and women knew when he was “in the mood” and managed to hide from him. After the attack ended, he behaved as if nothing had happened to him. Amnesia did not occur during the attack, but he could not tell about the details of what happened to him and around him during the episode. There are patients who, during a painful episode, become aggressive and commit acts of sexual violence.

5. “Monomania of murder” (K. Jaspers) or homicidomania is an impulsive urge to kill without any motivation in persons who normally do not show signs of pathological aggressiveness. G.V. Morozov and N.G. Shumsky illustrate the disorder with the following observation. The patient felt for five months that “something was pushing” him to kill his children. He could not “get rid of this urge, either day or night, or at work.” For the last three nights, he resisted this urge with all his might, and “looked at the children with bloodthirstiness.”

Finally, he said, “I was ready” to do it. “Before the murder, I didn’t think about anything other than killing and running away.” Having killed the sleeping children, he experienced “very great relief” until he came to the forest. In the forest he shouted: “I am a lost man.” He later said: “It had to happen, I couldn’t stop myself from committing this infanticide.” A similar example is given by A.S. Kronfeld, reporting on a patient who was forced by “some force” to throw himself into the water and swim until this “force” disappeared. In both cases, patients showed delusions of mastery (“something was pushing,” “some kind of force”) or, in other words, delusional depersonalization with the experience of alienation of their own painful impulses.

Impulsive drives, on the contrary, are experienced with a sense of appropriation of painful impulses, the latter at the time of a pathological episode are perceived as belonging to their ego. Perhaps, the following observation characterizes homicidomania more accurately. A 21-year-old patient (schizotypal disorder) reports that at times he has a “mad desire” to shoot people and “it would be nice with a machine gun.” “I would mow down everyone, I would not spare anyone, neither women nor children. At such moments, I really regret that I don’t have a machine gun or any other weapon with me.”

In response to the doctor’s doubt that it was difficult to believe how he, in general, not an evil person at all, could do such a thing, the patient replied: “I assure you, I would do it, you have no idea how much, how crazy it makes me feel.” I want to". “If I had any weapons,” he added, “I, of course, would try to get rid of them as quickly as possible. This desire appears suddenly, and I cannot predict when it will arise next.”

6. Suicidemania is a sudden, irresistible urge to commit suicide. For example: “Suddenly an acute reluctance to live arose. I immediately imagined that I would hang myself and where I would do it. I immediately found a rope, made a loop, soaped it, and wrote a note “thank you for everything, don’t blame me.” I put the rope in a bag and went to the place. On the way, I didn’t think about anything, didn’t remember anyone, it never occurred to me that my loved ones would suffer. An acquaintance stopped me. He asked what was wrong with me and said that I didn’t look like myself. I told him where I was going and why. He snatched the package from me, forcibly took me by the arms to his home, and gave me vodka to drink. I burst into tears and seemed to come to my senses. That was the end of it. This is the first time this has happened to me.”

7. Impulsive attacks of sadism - a sudden strong desire to cause someone pain, torment, suffering: “Suddenly I wanted to mutilate my father, gouge out his eyes, cut off his ears, nose, lips, tear out his tongue, cut his body with a knife or stab him with an awl. The desire was crazy. I could barely hold on, I thrashed about, bit my hands, banged my head against the wall, and then in a wild rage I broke everything in the house.” The patient did not experience sexual feelings.

8. Fugues or episodes of escape, during which the patient completely falls out of his familiar and home environment, often acquiring a new identity. Days, weeks, or even years later, such patients may come to their senses and find that they are in a different place. Usually they don’t remember how they got here or what they were doing all this time. Their actions during a painful episode can vary from simply going to the movies to traveling across the country, acquiring a new profession because they forget about the old one, leading a completely new life, as if starting from scratch. Fugues occur in some emergency situations that patients cannot cope with.

However, even before this, from time to time they experience conscious impulses to forget about everything and run away somewhere. During the period of such a “dissociative” fugue, outwardly the individual seems to those around him to be a completely normal person, but upon careful examination it turns out that with new activities he seems to be rejecting his previous behavior. R. Carson et al. illustrate the disorder with the following observation: B., 42 years old, a cook, attracted the attention of the local police by getting into a violent altercation with a cafe visitor. During interrogation, he identified himself as Bert Tate and said that he had arrived in the city a few weeks earlier. However, he did not have any documents and could not say where he had lived and worked before. He was asked to go to a local hospital for examination, to which he agreed.

The examination revealed no recent TBI, somatic abnormalities, or signs of alcohol or drug abuse. The patient correctly oriented himself in place and time, but did not remember his life at all before arriving in the city. This amnesia didn't seem to bother him too much. The next day he was released from the hospital.

Meanwhile, the police were checking the list of missing persons and discovered that B. matched the description of a certain D., who lived in another city and disappeared a month ago. D.'s wife was brought in for identification, and she confirmed that it was her husband. B. was noticeably alarmed. He stated that he did not know this woman. Before his disappearance, B., a company manager, faced serious problems at work and at home. The latter arose in a short period of time. At home, he became withdrawn and detached, constantly scolding his wife and children. Two days before his disappearance, he had a big fight with his son and left home, intending to live with friends.

This case is more suitable for the definition of hysterical twilight disorder of consciousness, it is very reminiscent of the phenomenon of multiple personality, but it is perhaps impossible to regard it as an impulsive attraction. Unfortunately, the ending of this story remains unknown. Such cases are not so rare, even if one judges their prevalence from television reports about people who have lost their autobiographical memory.

9. Dromomania (vagobandage, poriomania) - attacks of vagrancy with an inexplicable passion for changing places. The patients themselves explain the painful episodes by curiosity, a thirst for new experiences, and also by the fact that the usual way of life suddenly “gets boring”, begins to weigh down, and seems repulsive. Something like longing for unknown lands appears, and then an irresistible desire to go on a trip. Without resisting him, patients immediately abandon everything they are doing, the house and go “wherever they look” on the first train or plane they come across. The consciousness of the patients appears to be somewhat altered, and the reckless desire to wander is subjectively experienced as one’s own very acute desire. There are no significant memory impairments during the period of vagrancy.

Sometimes the onset of painful episodes dates back to childhood and adolescence. Illustration: patient K., 19 years old, was admitted to a psychiatric hospital due to bouts of vagrancy that lasted up to 1–2 months. It turned out that at the age of about four years, he began to disappear from home from time to time for the whole day, and it was not possible to find him. He returned home alone or accompanied by the police.

It turned out that he wandered around the city, traveling on different types of transport. No matter what his mother did (she locked him in the house, tried not to lose sight of him, asked neighbors to keep an eye on him, contacted the police), the boy still found an opportunity to escape from control and continued to run away. By the age of 6–7, the geography of his wanderings had expanded, he began to travel throughout the region, and, it seems, there was no place in it that he would not visit. He was not home for several days. It became impossible to find him. He returned home himself, dirty, hungry, sometimes bruised. At the same time, while away, he apparently began to steal, but only food or beg for it from local residents. From the age of 13–14 I began to travel outside the region, using trains and buses. He did not steal money from home; he apparently traveled as a “hare.”

The absences became longer, and he was absent from home for weeks. From the age of 16–17 he began traveling throughout the country. He preferred to fly by plane, not alone, but with one of his friends. It was unclear how he managed to do this without any money, but the police never detained him. The only thing the mother managed to do was to persuade the patient to at least report himself. Every time he disappeared from home, she received 10–15 telegrams informing her where he was at that time and where he intended to go next. During the examination, the patient turned out to be sociable and friendly, he talked about where he had been, and also that now he would like to travel around the world. He behaved adequately in the department; it was not possible to identify any symptoms of a mental disorder. The only thing he did not answer was questions about where he obtained funds for food, telegrams, and travel.

Most likely, he simply stole them. It was possible to establish that by this time he had begun to smoke hashish. After discharge from the hospital, the patient's behavior remained unchanged. He never finished school; attempts to place him in a vocational school were unsuccessful, since he was expelled for long absences. He left every time he heard on the radio or television that some important event was planned somewhere: a parade, competition, funeral ceremonies, something else. He said that he was interested in it and really wanted to visit the scene of the event.

At the age of 24 he was hospitalized again. This time he was clearly in a painful state: auditory deceptions of various contents, paranoia, and symptoms of mental automatism were detected. After treatment, the condition improved somewhat. Individual hallucinations and residual delusions remained, the patient noticeably changed in personal terms: he became fenced off, closed, lethargic, and emotionally monotonous. A diagnosis of paranoid schizophrenia was made. According to the follow-up data, in subsequent years the patient’s travels stopped, he was treated several times in a local psychiatric hospital, and died under unclear circumstances.

Bouts of vagrancy and vagrancy as a way of life are apparently different things. M. Gorky, O'Henry, and other authors wrote about tramps, describing them as asocial individuals, completely cut off from society. F.M. Dostoevsky, talking about one such tramp, suggested that this is the same type of eternal and restless wanderers who gave the world pioneers and discoverers of new lands and continents.

To the previously noted signs characterizing patients with impulsive drives, we believe it necessary to add that all of them are characterized by drives with contrasting content that contradict the image of the conscious self. Impulsive drives at this point converge with contrasting obsessions, including obsessive urges to do something as opposed to conscious motivation. From a diagnostic point of view, this feature of impulsive drives is probably of the greatest value, if we keep in mind that contrasting obsessions are most common in schizophrenia.

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Causes of dromomania

The main reason for sudden leaving home is mental disorder. These may be long-term consequences of previous mental trauma, psychopathy, obsessive-compulsive personality disorder. Psychologists state the fact that the desire to travel more often occurs in infantile people living in the world of their fantasies.

Attacks of dromomania occur in patients with hysteria, schizophrenia, epilepsy, and organic brain diseases. Epileptics and schizophrenics experience mood disorders, manifested in attacks of dysphoria - a sad and angry mood. During such attacks, patients often experience fear, which dominates the clinical picture. Fear unconsciously pushes for a change of environment, patients begin to abuse alcohol, go into binge drinking (dipsomania) or go on a vagrancy.

Also, attacks of dromomania often occur in children and adolescents. But such manifestations are considered false dromomania, since running away from the parental home has a number of explainable reasons. Most often these are conflict situations in the family, an unfavorable climate, for example, in families of alcoholics and drug addicts, as well as excessive mental and physical stress. Running away from home is a child’s defensive reaction to stress, but if such methods of response become constant, they can form a syndrome of irresistible desires and various types of addiction. False dromomania appears in temperamental and overly emotional children close to a state of passion. The escapes continue until the final development of the child’s emotional sphere. Escapes often have romantic overtones. The thirst for travel arises after watching a movie you like or after reading a book that interests you, following the example of your favorite hero.

One of the reasons for teenagers running away from home is boredom, which arises against the background of inactivity and indifference to different areas of life. And also often those children who are forced to do things they don’t like and are not interested in run away from home. For example, a child wants to take up drawing or photography, but I force him to go to a music school and a singing club. Leaving home is seen by the child as an opportunity to realize himself. Often children run away from the overprotection of parents who are prone to disorders such as dependence on the child and suffering from excess attention to him. Single runs away from home is not a fact for diagnosing dromomania. Frequent repeated escapes of children cause concern, but with good work by a psychologist and adjustments to the family environment, repeated attempts to escape can be stopped.

Unsocialized/socialized behavior disorder

Unsocialized behavior disorder is accompanied by aggression and antisocial acts directed at other children. This is the main distinguishing feature of the defect.

It is expressed by the inability to establish relationships with peers, rejection by children, and lack of close friends.

Relationships with adults are maintained or also disrupted. The child is rude and angry. He is an individualist who opposes authority. Typically:

• hooliganism;
• physical, mental violence, pugnacity;
• cruelty towards children and animals;
• damage to property.

Petya, 7 years old. Having entered the 1st grade, problems emerged in interacting with classmates. He was rude and confrontational. He did not establish friendly relations with anyone. I started about 15 quarrels a day. Overly cruel. During fights he inflicted serious injuries. Indifferent to other people's pain.

Violated discipline. He reacted to comments with verbal aggression. He was restless and talked in class. Uncontrollable, opposed to the regime. He called teachers villains. However, he showed high intellectual abilities and curiosity.

He was expelled from school for bad behavior. Refuses to study at home. He is interested in computer games and plays with a toy telephone. Fussy, hyperactive. Calms down when he finds something exciting to do. He loves to listen when his mother reads a book to him. He categorically does not want to return to school.

Socialized behavior disorder: characterized by aggressive, antisocial behavior of sociable adolescents who have long-term, established relationships with peers. They often become members of antisocial groups.

Illegal acts are typical: robbery, theft, assault.

Relationships with adults in power (teachers, parents) are disrupted, but with others they are able to maintain normal relationships.

Veronica, 13 years old, 7th grade student. Doesn't attend school. Absent from home for weeks. She is rude, aggressive, and confrontational with relatives.

Sloppy. He smokes, drinks, wears bright makeup. Takes up to 10 tablets of diphenhydramine to “catch glitches.” One day, my friend and I took pills, trying to commit suicide. Having experienced painful consequences, they did not repeat the attempt. They offered to try heroin, but she refused, fearing the outcome.

Takes money out of the house. One day I stole money from my mother at work. He is friends with older guys. Together they robbed my sister’s room, taking out money and jewelry, after a conflict with my sister’s husband.

The girl stopped attending the school her parents had recently transferred to when her classmates started calling her names. Then she set her older comrades against the offenders to intimidate them. Afterwards, Veronica visited the school to see if she would be teased further. Satisfied that there was no bullying, she never returned to school.

He mocks his younger brother and offends him. The girl's behavior changed after the death of her father and the birth of a brother from her mother's second marriage.

Treatment of dromomania

Treatment for dromomania depends on its nature, the person’s age and the stage of its development. In the case of childhood dromomania with isolated episodes of leaving home, consultation with a psychologist is sufficient. Treatment is not required, since the child’s psyche is just developing, gradually becoming stable. Over time, affective attempts to escape are eliminated, and the desire to travel fades away on its own.

In cases of repeated attacks of dromomania in both adolescents and adults, the help of a psychotherapist is necessary to find out the causes of the affective state and increase social responsibility. To eliminate a mental disorder, it is necessary to attend several psychotherapy sessions. In some cases, drug intervention is possible.

If dromomania has a clinical form, inpatient treatment and constant supervision by a psychotherapist using appropriate medications are mandatory. If, when determining the cause of dromomania, its connection with other mental illnesses is discovered: epilepsy, schizophrenia, psychopathy, then, first of all, it is necessary to treat the underlying pathology. In this case, the approach must be comprehensive. The patient is prescribed drug therapy, psychotherapeutic techniques and physiotherapy.

Yulia Savelyeva

Signs

Signs of dromomania:

• a person unexpectedly leaves home, does not take personal belongings with him, does not plan this;
• the person does not get in touch until the attack ends;
• the person does not tell anyone about his departure, abandons any activities and ignores any responsibilities;
• during an attack the person does not take care of himself;
• the person becomes aggressive.

In psychiatry, sexual dromomania is considered separately. The essence of this disorder is that the patient does not just go wandering, but goes to look for “adventures” in the form of casual sexual relationships. With a certain combination of a number of mental disorders, such a person is capable of rape or another crime.

How to fight?

Dromamania, like other syndromes, has its own stages of development:

1. The first attack in which a person runs away from home is usually nothing more than a reaction to severe stress, conflict with family or infringement of personal interests. At this stage, the person quickly comes to his senses and returns home.
2. Vagabondage is becoming a common response to problems at home or at work. Vagrancy drags on over time and leads to deep depression.
3. At the third stage, dromomania acquires a clinical character, in which it is difficult for a person to overcome his pathological cravings; he has practically no control over his actions during the next impulsive escape.

From the above, it becomes clear the need to start treatment as early as possible. Often this cannot be done without the help of a qualified psychologist. You may need to undergo treatment with antidepressants.

As a preventive measure, experts advise discussing with loved ones in a timely manner what causes internal anxiety, and finding compromises together.

Prevention

Preventing teenage vagrancy involves creating comfortable living conditions. A child who is loved and protected, and raised correctly, will not leave the family. If you have mental disorders, you should definitely consult a child psychiatrist. The state must monitor those who live in boarding schools and dysfunctional families. The emergence of a craving for vagrancy is most often observed in these children.

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Syndromes not related to the functioning of a specific organ system

Symptomatic groups in SRL are also classified according to other criteria.

Asthenic syndrome often accompanies the disease. Its usual manifestation is considered to be rapid fatigue with neuropsychic hyperexcitability. I am worried about a headache that gets worse during mental stress and in the afternoon. The patient feels numbness in the head, tingling in the back of the head. The feeling of a stale head, familiar to many, appears.

Depression is a typical phenomenon for somatoform patients and affects half of those suffering from the disease.

Dysmorphophobia is dissatisfaction with the condition of a certain part of the body, the belief in the existence of a physical defect, the prevalence of an unpleasant odor. The main criteria for the syndrome are:

• delusion of having a physical defect;
• confidence that people laugh at the patient;
• Bad mood;
• spend a long time looking at themselves in the mirror;
• they don't like to be photographed.

Anorexia nervosa . The patient, often a woman, deliberately limits himself to food if he has an appetite. They restrain themselves so as not to gain weight. Distinctive features:

• weight loss up to 25%;
• refusal to eat;
• absence of menstruation.

Conversion is a partial or complete loss of functioning of a body part under the influence of psycho-emotional stress. Options:

• tics;
• paresthesia, anesthesia, paresis of the limbs;
• nervous blindness, deafness;
• anosmia – loss of sense of smell;
• pseudoceisis - false pregnancy.